Cetuximab-Related Skin Toxicity as a Predictive Marker for Treatment Response and Prognosis in Recurrent/Metastatic Head and Neck Cancer Patients Treated with Cetuximab and Chemotherapy Combination

Abstract Objective: Cetuximab (Cmab)-related skin toxicity is a frequent adverse reaction in the treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (r/mSCCHN). We wanted to evaluate whether skin toxicity can be used as a prognostic marker for the treatment of patients who are receiving Cmab therapy for r/mSCCHN. Methods: A retrospective review was conducted of demographic data, prognostic features, treatment responses, Cmab-related skin toxicity, and dates of diagnosis, treatment initiation, progression, and death for r/mSCCHN patients treated with Cmab at Kocaeli University Medical Oncology Department between 2010 and 2019.Significance of the results has been evaluated by using SPSS (20.0 SPSS Inc., Chicago, IL, USA.) statistical program. Results: A total of 77 patients were enrolled.A significant association was found between Cmab-related skin toxicity and longer survival in patients with r/mSCCHN. Patients without skin toxicity had shorter progression-free survival (PFS) compared to those with grade 1 and grade 2 skin toxicity. Notably, patients who had grade 3 skin toxicity exhibited longer overall survival (OS) and significantly better PFS than those without skin toxicity, as well as those with grade 1 or grade 2 toxicity. No significant OS difference was observed between patients with grade 1 or grade 2 toxicity and those without skin toxicity. Conclusions: Skin toxicity, particularly grade 3, is associated with improved prognosis, with longer OS and PFS. Grade 1 and grade 2 skin toxicity are linked to better PFS compared to no toxicity. These findings suggest that preventive strategies to manage Cmab-related skin toxicity, especially grade 2 and grade 3, may enhance patient outcomes.